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首页> 外文期刊>BMJ Open >Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework
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Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework

机译：使用访谈和焦点小组进行定性研究，以探索在理论领域框架的指导下社区药房抗菌管理的现状和潜力

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Objectives Community pharmacists and their staff have the potential to contribute to antimicrobial stewardship (AMS). However, their barriers and opportunities are not well understood. The aim was to investigate the experiences and perceptions of community pharmacists and their teams around AMS to inform intervention development.Design Interviews and focus groups were used to explore the views of pharmacists, pharmacy staff, general practitioners (GPs), members of pharmacy organisations and commissioners. The questioning schedule was developed using the Theoretical Domains Framework which helped inform recommendations to facilitate AMS in community pharmacy.Results 8 GPs, 28 pharmacists, 13 pharmacy staff, 6 representatives from pharmacy organisations in England and Wales, and 2 local stakeholders participated.Knowledge and skills both facilitated or hindered provision of self-care and compliance advice by different grades of pharmacy staff. Some staff were not aware of the impact of giving self-care and compliance advice to help control antimicrobial resistance (AMR). The pharmacy environment created barriers to AMS; this included lack of time of well-qualified staff leading to misinformation from underskilled staff to patients about the need for antibiotics or the need to visit the GP, this was exacerbated by lack of space. AMS activities were limited by absent diagnoses on antibiotic prescriptions.Several pharmacy staff felt that undertaking patient examinations, questioning the rationale for antibiotic prescriptions and performing audits would allow them to provide more tailored AMS advice.Conclusions Interventions are required to overcome a lack of qualified staff, time and space to give patients AMS advice. Staff need to understand how self-care and antibiotic compliance advice can help control AMR. A multifaceted educational intervention including information for staff with feedback about the advice given may help. Indication for a prescription would enable pharmacists to provide more targeted antibiotic advice. Commissioners should consider the pharmacists’ role in examining patients, and giving advice about antibiotic prescriptions.
机译：目标社区药剂师及其员工有可能为抗菌素管理（AMS）做出贡献。但是，他们的障碍和机遇尚未得到很好的理解。目的是调查社区药剂师及其在AMS周围的团队的经验和看法，以为干预发展提供信息。设计访谈和焦点小组用于探讨药剂师，药房人员，全科医生（GPs），药房组织成员和专员。通过使用理论领域框架制定了询问时间表，该框架有助于提供建议以促进社区药房中AMS的使用。结果8名全科医生，28名药剂师，13名药房人员，6名英格兰和威尔士药房组织的代表以及2名当地利益相关者参加了会议。这些技能有助于或阻碍不同级别的药房人员提供自我保健和合规性建议。一些员工不知道提供自我护理和依从性建议以帮助控制抗菌素耐药性（AMR）的影响。药房环境为AMS设置了障碍;其中包括缺乏合格的员工时间，导致从技能不足的员工到患者关于抗生素需求或需要去GP的错误信息，这是由于空间不足而加剧的。由于缺乏对抗生素处方的诊断，AMS的活动受到了限制。数名药房工作人员认为，进行患者检查，质疑抗生素处方的理由并进行审核将使他们能够提供更具针对性的AMS建议。结论需要采取干预措施来克服缺乏合格人员的情况，时间和空间为患者提供AMS建议。工作人员需要了解自我保健和抗生素依从性建议如何帮助控制AMR。多方面的教育干预措施可能会有所帮助，包括为员工提供信息并提供反馈意见。处方说明将使药剂师能够提供更有针对性的抗生素建议。专员应考虑药剂师在检查患者以及提供抗生素处方方面的建议。

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